Frequently Asked Questions
HiMAT was specifically developed to be quick and easy to use in
almost any clinical setting. It has minimal time, equipment and
training requirements. If you experience any difficulty or require
a point to be clarified, please do not hesitate to contact the developers
of the HiMAT to discuss your questions.
are four frequently asked questions in relation to the HiMAT;
Does the client have to perform the warm-up/practice trial?
The warm-up or practice trial is important before a performance
is recorded. Retest reliability studies on high-level mobility performance
following TBI show a practice effect is possible even in patients
with chronic injuries.
Does the patient have to actually run for the running item or is
a fast walk acceptable?
A ‘flight phase’ or ‘no-contact phase’ is
essential for the running, skipping, hopping and bounding items.
If a flight phase is not consistently performed between all foot
contacts during the test, a fail is recorded for these items. Therefore
a very fast walk is not acceptable as a run. Similarly, a very large
step is not acceptable as a bound.
What happens if we don’t have a flight of 14 steps?
A full-flight of 14 steps needs to be used where-ever possible for
the stair items because the performance quartiles for scoring are
based on this number of steps. In the event that only a smaller
number of steps are available, the time achieved by the patient
has to be transformed before a score can be assigned. For example,
if a time is recorded on a flight of 10 steps, this time needs to
be multiplied by 14/10. The calculation is
time x 14/number of steps = converted HiMAT time
investigate if a reduced number of stairs was valid for HiMAT scoring,
a sample of 20 people with extremely severe traumatic brain injuries
were tested on flights of 6, 8, 11 and 14 stairs.
performed the four trials in a random order to control for the effect
of ordering and fatigue. Performances were classified as ‘dependent’
or ‘independent’ and times were recorded and transformed
so that a converted score could be calculated. To calculate the
converted score for the flight of 6 stairs, the timed performance
was multiplied by 14/6. This procedure was repeated for the flight
of 8 stairs (14/8) and 11 stairs (14/11).
scores were calculated for ‘Up Stairs’ and ‘Down
Stairs’ separately (possible range 0-9) and compared to the
score obtained on the full flight of 14 stairs.
correlations between the scores obtained for the full flight of
14 stairs and the converted scores for 6, 8, and 11 stairs were
generally very high, ranging from .80 to .98 for ‘Up Stairs’
and .92 to .95 for ‘Down Stairs’. Subjects did not change
their method (reciprocal or rail use) of stair ascent or descent
between the different flight trials.
comparing the mean performances between the full flight of 14 stairs
and the converted scores for 6, 8, and 11 stairs, no significant
differences were identified for ‘Up Stairs’. There was
a trend for the subjects to perform the flight of 6 stairs at a
faster speed than the full flight of 14 stairs, but this difference
was not significant.
comparing the mean performances for ‘Down Stairs’, subjects
performed at significantly faster speeds for flights of 6 and 8
stairs than the full set of 14 stairs.
average, the subjects scored 0.5 points higher when performing on
the flight of 6 stairs when compared to the full flight of 14 stairs
for the ‘Up Stairs’ and ‘Down Stairs’ tasks.
When considering the standard error of measurement, the upper 95%
confidence interval for improvement was, at most, less than 1 point.
clinical significance of these results are;
Subjects may perform at a significantly faster speed when descending
smaller flights of stairs.
Scores converted from flights of 6 stairs may inflate ‘true’
HiMAT total scores, but scores converted from flights of 11 or
more stairs seem to be valid.
When converting a score from a flight of 6 stairs, the maximum
a stair item score may inflate the total HiMAT score is 2 points
(1 point for ‘Up Stairs’ and 1 point for ‘Down
The impact of testing on a reduced number of stairs on total HiMAT
scores is of minor importance for the majority of patients and
clinicians as assessments are normally repeated in the same location.
It is more important to acknowledge the potential impact on total
scores when changing assessment location if patients are transferred
What are the normative values for the HiMAT?
No normative values have been developed for the HiMAT yet. It is
planned that normative values will be developed for younger and
older adults and males and females.